There have been few histochemical and electron microscopic studies about the transport of ICG in liver tissue, due largely to limitation on the nature of the dye. This report is concerned with ICG transport as it is recognized by fixation procedure. By this procedure the ICG particle can be demonstrated to be transferred from Disse's space to bile canaliculi through hepatocellular organelles. ICG can be precipitated by ferric chloride, and then pre-fixed solution is prescribed as 2.5% glutaraldehyde in 0.05M cacodylate buffer (pH 7.4) containing 0.5% ferric chloride. The precipitate is sulfurated by yellow ammonium sulfide because the precipitate is soluble in ethyl alcohol and in propylene oxide. The liver of Wister strain rats was taken out at 30 seconds, 1 minute and 3 minutes after a single injection of ICG 10mg/Kg body weight through portal or tail vein. The tissue was fixed in pre-fixed solution described above. After sulfurated for 5 minutes specimens were fixed again in osmium tetraoxide for 90 minutes and dehydrated in a serial concentration of ethyl alcohol. Specimens were stained with uranyl acetate and lead citrate for eletron microscopic observation. The ICG particles were revealed to be dense particles with 200Å diameter on coated collodion grid. The ICG particles were observed on the surface of endothelial cells in sinusoid and Disse's space on the specimens at 30 seconds. In liver cells the particles were found between membrane of RER and SER, and also in lysozomes. Numbers of ICG particles became less in sinusoid and Disse's space and more in liver cells during the time at 3 minutes. In bile canaliculi the particles were observed at 60 seconds. From these results it is concluded that under electron microscope the ICG particles can be revealed by above described method, and it is suggested that ICG transports from sinusoid into bile canaliculi through RER, SER and lysozomes.
Anti-tissue antibodies were examined by the immunofluorescence method in the sera of 168 subjects, including 111 patients with various liver diseases, patients with nonhepatic conditions and control subjects. Unfixed 4μ thick cryostat sections of rat stomach, liver and kidney were treated with various dilutions of patient's serum and then stained with fluorescent antihuman IgG. The results were as follows: 1) All of the 4 patients with subacute hepatitis showed positive gastric smooth muscle antibody. One was also positive for anti-nuclear antibody in high titers. 2) Eight of the 9 patients with primary biliary cirrhosis had positive antibodies to the gastric parietal cell, renal tubular cell and gastric smooth muscle. One showed positive anti-nuclear antibody in high titers. The levels of antibodies expressed by the maximum dilution of serum giving positive staining were relatively high in most patients. In contrast, the patients with extrahepatic biliary obstruction and intrahepatic cholestasis showed a very low incidence of antibodies and when positive, they were very low in titer. Thus, these studies are of great value in the differential diagnosis between primary biliary cirrhosis and extrahepatic biliary obstruction or intrahepatic cholestasis. 3) Gastric smooth muscle antibody was positive in 8 of 12 patients with hepatoma. Two of those who were positive also had anti-nuclear antibody in low titers. It was also demonstrated in relatively high incidences in patients with chronic active hepatitis, acute hepatitis and cirrhosis. 4) The corticosteroid therapy decreased the dilution titers of these antibodies to an appreciable extent. 5) In other liver diseases, anti-tissue antibodies were infrequents, and if present, low in titer. These findings are compatible with the concept that autoimmune reactions involved to a significant extent in the developement and subsequent course of liver disease, especially of chronic liver diseases.
P-S test (pancreozymin-secretin test) has been widely employed in order to evaluate the exocrine function of the pancreas. In addition, this test also has been used for the detection of biliary disorders. In the present paper, we discuss the evaluation of P-S test as a diagnostic significance of the diseases of the biliary tract. During these 4 years we have performed 1200 cases of P-S test. We dealt with recent successive 300 cases in this study, including 16 cases of normal group, 30 cases of gallstone and cholecystitis, 8 cases of carcinoma of the gallbladder and bile ducts, 12 cases of carcinoma of the pancreas and the duodenal papilla, 18 cases of cholecystectomized patient, 16 cases of hepatitis and cirrhosis, 12 cases of colitis, 15 cases of gastro-duodenal ulcer, 19 cases of chronic pancreatitis, and others. In the normal group, the mean of the icteric index and its standard deviation were calculated in the fractions following the injection of pancreozymin and secretin. From these data we draw the range of normal values as the diagnostic chart. In the normal cases, the concentration of bile reaches its peak following ten minute fraction after the injection of pancreozymin, and the bile abruptly disappears in the duodenal contents after the stimulation by secretin. On this diagnostic chart, 63 cases (93%) of organic disorders of the biliary tract were scaled out from the normal range at least in a part. In patients who have organic disorders of biliary tract, concentrated bile following the injection of pancreozymin was not observed and bile concentration of the serial specimens from duodenal contents was higher than normal cases after injection of secretin. The possibility of both false-negative and false-positive were about 6%.
This experiment is designed to study the role of the distal 1.5cm of antral cuff retained in pylorus-preserving gastrectomy. Heidenhain pouch secretions in response to meal were collected and assayed for volume and acidity. After the pylorus-preserving gastrectomy, the mean volume of five hour pouch secretion was 12.1ml. The reduction in secretory volume was 57.4 per cent. The mean acid concentration fell to a value of 75.1mEg/l, a reduction of 33.8 per cent. The mean acid output fell to a value of 0.92mEg, a reduction of 71.7 per cent. But, gastric secretion of the dog that showed gastric stasis was not sufficiently reduced after the operation. In temporal relationships between the stimulus and secretory response, gastric secretory pattern after gastrectomy was similar to that of the control. It is suggested that acid output in pylorus-preserving gastrectomy decreases adequately, but the 1.5cm of antral cuff is able to be stimulated strongly to release gastrin by mechanical distention.
Twenty two years old woman was admitted to the Tokyo Medical College Hospital, complaining of sense of fullness in the left hypochondrium. Physical examination revealed a first-sized tumor without tenderness below the left costal margin. By laparoscopical examination, a part of the cystic tumor between the left lobe of the liver and the enlarged spleen was seen. Based upon the findings of selective angiography of the splanchinic artery and scintigram of the liver and spleen, the tumor seemed to be cyst of the spleen. Splenectomy including cyst was performed and cyst with a single cavity arising from the splenic portal was recognized, in which about 1000ml fluid with dark brown hue was contained. Tumor was size of 23×17×13cm and weighed 1380gr. Histologically, epidermoid cyst was confirmed. This patient had no early history of any disease or any trauma in the abdominal organs. Therefore, it might be impossible to clarify the cause of cystic change. In the light of up to now reported cases of splenic cyst, this case stands No. 17 in cases of epidermoid cyst of the spleen in Japan. This patient is now in good health.
The purpose of this report is to describe observation on the three dimensional appearances of the surface and section of atypical epithelium (ATP) in contrast to other protruded lesions of the gastric mucosa examined by the scanning electron microscopy (JSM-U3). Three cases of protruded early gastric cancers, two cases of regenerative polyps (as classified by Ming), and two cases of ATP were subjected to the present study. As compared with normal gastric mucosa which showed regular openings of gastric pits, the surface of ATP revealed some irregular patterns with cleft-like or elliptical gland openings with occasionally funnel-shaped of varying size. The surface of regenerative polyps showed either huge elliptical gland openings surrounded by the thick walls or sausage like protrusions with sparse gland openings. The surfaces of the protruded early gastric cancers presented more irregular patterns with greatly deformed gland openings or without gland openings. The cells in ATP were arranged regularly and densely with thick microvilli and surface area of each cells was smaller than that of normal epithelial cells of gastric mucosa. The cut surface in ATP revealed tall cells and occasionally enlarged glandular cavities with complex branches of somewhat irregular distribution. In deeper layers many adjoining cyst formations were observed. One of the interesting findings of the structures of ATP was that a large cyst in deeper layer was connected with upper cavity of ATP with a narrow neck. These findings seem to be fairly characteristic of ATP structures.